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Psychopaths aren't what they used to be

People with aggressive tendencies can't change, but they can adapt, says Harriet Swain.

Our monthly guide to the various conferences taking place around the world.

How many psychopaths do you know? None? Take another look at your boss, your MP, your ambitious work colleague. "Many really good psychopaths, particularly those who are educated - the highly functioning ones who look good, speak well - don't go robbing banks and hitting people over the head but look for organisations where they can prosper," warns Robert Hare, professor of psychology at the University of British Columbia and principal speaker at a conference on the assessment and management of dangerous offenders.

Recent brain-imaging research shows that psychopaths think differently from the rest of us, he says. Showing them an emotional picture or speaking emotive words does not seem to activate the same areas of the brain that are activated in others - it activates parts of the brain that process linguistic material.

Hare argues that not being able to change them as individuals does not mean you cannot change their behaviour. "First, you need to understand who you are dealing with," he says. "Once you have done that, it should be possible to set up strategies to deal with them and minimise their impact."

The importance of looking at the individual and at their environment is a key theme of the conference. It is organised by the Northern Ireland branch of the British Psychological Society, and it will examine cases in the Province where sentences given to violent offenders have been criticised by victims as too lenient. With the Northern Irish mental health and learning disability review due to report next year, this is a pertinent issue. The subject has wider UK resonance too: a new Mental Health Act is due next year and the introduction of a treatment plan for psychopaths in prisons is planned.

The conference brings together experts from academia, special hospitals, the Government, police (even the Federal Bureau of Investigation) to discuss the best way of managing people who have committed or threaten to commit violent acts. While in England and Wales violent offenders with mental disorders are usually treated in special hospitals, in Northern Ireland and in Canada, where Hare is based, they go to prison. Which strategy offers the best way of reducing risks to the public is a hot topic.

Clive Hollin, professor of criminological psychology at Leicester University and one of the conference speakers, says that, in the past, academics and practitioners who worked with mainstream offenders tended to work separately from those who worked with mentally disturbed offenders but this is changing. Research shows that some environments are more likely to trigger violence - one that is subversive or threatening, or too hot or crowded, for example. To understand violent behaviour in a mentally disordered person, it is essential to understand it in the population generally, he says, and similar strategies to tackle it can be used for both. He suggests that those dealing with "normal" aggressive people can benefit from an approach that focuses on the person rather than on the violent act. This is key to the programme Risk Assessment Management and Audit Systems (Ramas), which looks at offenders as individuals, rather than in terms of their behavioural problems.

Margaret O'Rourke, director of behavioural science at University College Cork and a consultant forensic clinical psychologist, has carried out research on methods of managing dangerous offenders by asking what a human being needs to thrive and be happy. "The most important thing for people with personality disorder is to show them how to regulate themselves: their emotions, cognition, behaviour." While she agrees that past behaviour is often predictive of future actions, she stresses it's not always so; there is a possibility of changing, if not the person, at least the risk they pose. "A lot of people with personality disorders are described as untreatable. Ramas challenges that."

While psychopaths are a special case, says Hare, there is still the possibility of reducing risk where they are concerned. The key issue is to put strategies in place early - and to know who the psychopaths are.